Background: The devastating impact of AIDS in the world especially in sub-Saharan Africa has led to an unprecedented global effort to ensure access to antiretroviral (ARV) drugs. Given that medication-taking behavior can immensely affect an individual's response; ART adherence is now widely recognized as an 'Achilles heel' for the successful outcome. The present study was undertaken to investigate the rate and predictors of adherence to antiretroviral therapy among HIV-infected persons in southwest Ethiopia.

BackgroundPerceived stigma and lack of awareness could contribute to the late presentation and low detection rate of tuberculosis (TB). We conducted a study in rural southwest Ethiopia among TB suspects to assess knowledge about and stigma towards TB and their health seeking behavior.MethodsA community based cross sectional survey was conducted from February to March 2009 in the Gilgel Gibe field research area. Any person 15 years and above with cough for at least 2 weeks was considered a TB suspect and included in the study. Data were collected by trained personnel using a pretested structured questionnaire. Logistic regression analysis was done using SPSS 15.0 statistical software.ResultsOf the 476 pulmonary TB suspects, 395 (83.0%) had ever heard of TB; “evil eye” (50.4%) was the commonly mentioned cause of TB. Individuals who could read and write were more likely to be aware about TB [(crude OR = 2.98, (95%CI: 1.25, 7.08)] and more likely to know that TB is caused by a microorganism [(adjusted OR = 3.16, (95%CI: 1.77, 5.65)] than non-educated individuals. Males were more likely to know the cause of TB [(adjusted OR = 1.92, (95%CI: 1.22, 3.03)] than females. 51.3% of TB suspects perceived that other people would consider them inferior if they had TB. High stigma towards TB was reported by 199(51.2%). 220 (46.2%) did not seek help for their illness. Individuals who had previous anti-TB treatment were more likely to have appropriate health seeking behavior [(adjusted OR = 3.65, (95%CI: 1.89, 7.06)] than those who had not.ConclusionThere was little knowledge about TB in the Gilgel Gibe field research area. We observed inappropriate health seeking behavior and stigma towards TB. TB control programs in Ethiopia should educate rural communities, particularly females and non-educated individuals, about the cause and the importance of early diagnosis and treatment of TB.

Background: Disclosing HIV test results to one's sexual partner allows the partner to engage in preventive behaviors as well as the access of necessary support for coping with serostatus or illness. It may motivate partners to seek testing or change behavior, and ultimately decrease the transmission of HIV. The present study was undertaken to determine the rate, outcomes and factors associated with HIV positive status disclosure in Southwest Ethiopia among HIV positive service users.

Epidemiological studies in developing countries suggest that intestinal parasite infection may reduce the risk of asthma. Because this evidence is all derived from adults and older children, we have investigated the relation between parasite infection, wheezing, and allergen skin sensitization in nested case-control studies drawn from a survey of 7,155 children aged 1 to 4 years living in urban and rural areas of Jimma, Ethiopia. Infection with parasites was common, predominantly with Trichuris (54%), Ascaris (38%), and hookworm (10%). Wheezing in the past year was significantly more prevalent in urban (4.4%) than rural children (2.0%), and was less prevalent in those infected with Ascaris (age, sex, and urban/rural adjusted odds ratio, 0.5; 95% confidence interval, 0.3 to 0.9), particularly in relation to high-intensity infection. Similar, although nonsignificant, associations were found for hookworm (adjusted odds ratio, 0.6; 95% confidence interval, 0.2 to 1.8), but there was no suggestion of any relation to Trichuris infection. Dermatophagoides pteronyssinus and cockroach (Blattella germanica) skin sensitization was more prevalent in rural than urban children, and was unrelated to wheeze. We conclude that Ascaris and possibly hookworm infection protects against wheeze in young Ethiopian children, and that this effect is not mediated by inhibition of allergen sensitization.

Background: Diabetes Mellitus is common metabolic disease worldwide. Its complications in the Ethiopian

BackgroundIn Ethiopia, pesticides are widely used for a variety of purposes. The occurrence of contamination and poisoning for farmers is highly reported due to unsafe handling practices and their usage. We assessed knowledge, attitudes and experiences of previous pesticide exposure, and related health problems among farmers who use irrigation in Jimma Zone, Southwest Ethiopia.MethodsA community based cross-sectional study was conducted among farmers living in the zone. Respondents were 796 irrigation farmers from 20 kebeles (lowest administration unit) in Jimma Zone. Data were collected using a pretested and structured questionnaire via face-to-face interviews. Both descriptive and inferential statistics analysis were performed. A binary logistic regression was used to identify factors associated with attitudes of farmers towards the safe use of pesticides at P value of ≤ 0.05 in the final model.ResultsAmong the participants, 54.4% (95%CI, 50.7–58%) knew at least one pesticide control method and 53.7% had positive attitudes towards safe use of pesticide. The mean score of attitudes was found to be 3.9(±0.4). Knowledge including each of the following: the names of the pesticides (AOR, 0.41; 95%CI, 0.25–0.67), methods of pest control and the use of gloves during pesticide exposure (AOR, 1.52; 95%CI, 1.07–2.16) was found to be independent predictor of the farmers’ attitudes about safe use of pesticides. Past exposure of pesticide was reported by 89.6% of farmers. Participants reported ingestion (88.9%) and inhalation (90.4%) as possible mechanisms of pesticide exposure. Nearly 42% of farmers had never used any personal protective equipment (PPE) to protect themselves against pesticide exposure. Farmers reported several health complications, which were perceived as complications of pesticide exposure, including: headache, nausea and vomiting, skin rash and irritation and abdominal pain.ConclusionsThe study exposed the existence of high probability of pesticide exposure, the low safe use of pesticide and the low use of PPE. However, but farmers had positive attitudes towards safe use of pesticides. These findings appeal for the development of effective public health strategies to improve farmers’ awareness and safe use of PPE. In addition, there is a need to inform farmers about integrated pest management to prevent severe health complications, which may occur as a result of unsafe and inappropriate use of pesticides.

BackgroundTuberculosis (TB) is among the leading causes of morbidity and mortality worldwide. More than 70% of the deaths of TB patients occur during the first two months of TB treatment. The major risk factors that increase early death of TB patients are being positive for human immunodeficiency virus (HIV), being of old age, being underweight or undergoing re-treatment.ObjectiveTo assess the time of reported deaths and associated factors in a cohort of patients with TB during TB treatment.MethodsAn institution-based retrospective cohort study was analyzed in Dangila Woreda, Northwest Ethiopia from March 1st through March 30, 2014. All TB patients registered in the direct observed treatment (DOTs) clinic from 2008–2012 were included in the study. Data were entered into EpiData and exported to SPSS for analysis. The survival probability was analyzed by the Kaplan Meier method and Cox regression analysis was applied to investigate factors associated with death during TB treatment.ResultsFrom a total of 872 cases registered in TB registry log book, 810 were used for the analysis of which 60 (7.4%) died during the treatment. The overall mortality rate was 12.8/1000 person months of observation. A majority of TB deaths 34 (56.7%) occurred during the intensive phase of the treatment, and the median time of death was at two months of the treatment. Age, HIV status and baseline body weight were independent predictors of death during TB treatment.ConclusionsMost deaths occurred in the first two months of TB treatment. Old age, TB/HIV co-infection and a baseline body weight of <35 kg increased the mortality during TB treatment. Therefore, a special follow up of TB patients during the intensive phase, of older patients and of TB/HIV co-infected cases, as well as nutritionally supplementing for underweight patients may be important to consider as interventions to reduce deaths during TB treatment.

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